The joint between the incus and stapes bones (the incudostapedial joint) is commonly eroded by infection or cholesteatoma. If it is still intact, or only a short segment is missing, bone cement can be used to strengthen or reconstruct it.
There are countless ways that the ossicles can be reconstructed when the long process of the incus bone is absent. The patient’s own tissue is usually used in the first surgery with cholesteatoma removal.
If the incus and malleus are too diseased then prostheses are used.
When the incus and arch of the stapes are absent, a total ossicular replacement prosthesis (TORP) is used.
